Prevalence and pattern of cognitive impairment in rural and urban populations from Northern Portugal

<p>Abstract</p> <p>Background</p> <p>Despite worldwide recognition of the burden of dementia, no epidemiological data is yet available in Portugal. The objective of this study is to estimate the prevalence and describe the pattern of cognitive impairment with dementia or no dementia (CIND) in rural and urban populations from Northern Portugal.</p> <p>Methods</p> <p>Two random samples of residents aged 55 to 79 years in rural and urban communities were drawn from the health centres registries to be screened for cognitive impairment. The screening criteria for dementia were an abnormal Mini-Mental State Examination (MMSE) score or a Blessed Dementia Scale score. After excluding those who tested positive for dementia, cut-off points for CIND were set at 1 standard deviation below the mean of the MMSE according to educational level. All those who screened positive either for dementia or CIND were examined by a neurologist for establishing a definitive diagnosis.</p> <p>Results</p> <p>The prevalence of cognitive impairment was higher in rural than in urban populations, 16.8% (95% CI: 14.3-19.8%) vs. 12.0% (95%CI: 9.3-15.4%), with a rural/urban prevalence ratio (PR) of 2.16 (95% CI: 1.04-4.50) in the eldest and 2.19 (95% CI: 1.01-4.76) in persons with vascular risk factors. The prevalence of dementia was 2.7% (95% CI: 1.9-3.8%) with a rural/urban PR = 2.1 and the prevalence of CIND was 12.3% (95% CI: 10.4-14.4%) and PR = 1.3. The prevalence of dementia increases exponentially with age and in those with cerebrovascular disease or other comorbid conditions while the prevalence of CIND, besides these factors, is also higher in persons with low levels of education or vascular risk factors. Alzheimer's and vascular disease were equally likely aetiologies of dementia (38.7%), the later more common in men PR(F:M = 0.3) as opposed to the former PR(F:M = 2.0). Vascular CIND, associated either with cerebrovascular disease or vascular risk factors was more frequent (39.7%) then depression (18.4%) or any other aetiology.</p> <p>Conclusions</p> <p>The prevalence of cognitive impairment is higher in rural compared with urban populations. This is shown in the synergy between age and rurality, with the rural/urban prevalence ratio increasing with age. In this relatively young population from Northern Portugal, cerebrovascular disease as well as vascular risk factors account for 48% of overall cognitive impairment.</p

Facial paralysis associated with acute otitis media

Acute otitis media with facial paralysis is not a very frequent association. AIM: the goal of the present investigation was to asses the evolution of facial paralysis caused by acute otitis media. STUDY FORMAT: clinical-retrospective. MATERIALS AND METHODS: we studied 40 patients with this association, from a total of 2758 cases of facial paralysis seen during this time in the department of facial nerve disorders. All the patients were clinically assessed and had epidemiological data, prognostics and evolution. RESULTS AND CONCLUSION: the paralysis was of sudden onset in 95% of the cases. Recovery was of 85% for grade I (House-Brackman) and 15% for grade II (House-Brackman). Treatment was clinical, with antibiotics and steroids - yielding good results. In those patients with electrical bad prognosis, facial nerve decompression turned their evolution into a favorable one.A otite média aguda com paralisia facial não é uma associação muito freqüente. OBJETIVO: O objetivo deste trabalho foi avaliar a evolução da paralisia facial decorrente de otite média aguda. FORMA DE ESTUDO: Clínico retrospectivo. MATERIAL E MÉTODO: Foram estudados 40 pacientes com esta associação de patologias, num total de 2758 casos de paralisa facial atendidos neste período no setor de distúrbios do nervo facial. Todos os pacientes foram avaliados clinicamente com dados epidemiológicos, prognósticos e evolutivos. RESULTADOS E CONCLUSÃO: A paralisia foi súbita em 95% dos casos. A recuperação foi de 85% para o grau I (House-Brackman) e 15% para o grau II (House-Brackman). O tratamento foi clínico com antibiótico e corticoterapia com bons resultados. Nos pacientes com mau prognóstico elétrico a descompressão do nervo facial fez com que a evolução fosse favorável.Universidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Departamento de Otorrinolaringologia e Cirurgia de Cabeça e PescoçoUNIFESP, EPM, Depto. de Otorrinolaringologia e Cirurgia de Cabeça e PescoçoSciEL

Alterations in ubiquitin ligase SIAH-2 and its corepressor N-COR after P-mapa immunotherapy and anti-androgen therapy: new therapeutic opportunities for non-muscle invasive bladder cancer

The present study describes the role of the ubiquitin ligase Siah-2 and corepressor N-CoR in controlling androgen receptor (AR) and estrogen receptors (ERa and ER beta) signaling in an appropriate animal model (Fischer 344 female rats) of non-muscle invasive bladder cancer (NMIBC), especially under conditions of anti-androgen therapy with flutamide. Furthermore, this study describes the mechanisms of a promising therapeutic alternative for NMIBC based on Protein aggregate magnesium-ammonium phospholinoleate-palmitoleate anhydride (P-MAPA) intravesical immunotherapy combined with flutamide, involving the interaction among steroid hormone receptors, their regulators and Toll-like receptors (TLRs). Our results demonstrated that increased Siah-2 and AR protein levels and decreased N-CoR, cytochrome P450 (CYP450) and estrogen receptors levels played a critical role in the urothelial carcinogenesis, probably leading to escape of urothelial cancer cells from immune system attack. P-MAPA immunotherapy led to distinct activation of innate immune system TLRs 2 and 4-mediated, resulting in increase of interferon signaling pathway, which was more effective in recovering the immunosuppressive tumor immune microenvironment and in recovering the bladder histology features than BCG (Bacillus Calmette-Guerin) treatments. The AR blockade therapy was important in the modulating of downstream molecules of TLR2 and TLR4 signaling pathway, decreasing the inflammatory cytokines signaling and enhancing the interferon signaling pathway when associated with P-MAPA. Taken together, the data obtained suggest that interferon signaling pathway activation and targeting AR and Siah-2 signals by P-MAPA intravesical immunotherapy alone and/or in combination with AR blockade may provide novel therapeutic approaches for NMIBC8544274443CONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICO - CNPQFUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DE SÃO PAULO - FAPESP490519/2011-32012/20706-2; 2012/13585-

Unveiling the Dynamics of the Universe

We explore the dynamics and evolution of the Universe at early and late times, focusing on both dark energy and extended gravity models and their astrophysical and cosmological consequences. Modified theories of gravity not only provide an alternative explanation for the recent expansion history of the universe, but they also offer a paradigm fundamentally distinct from the simplest dark energy models of cosmic acceleration. In this review, we perform a detailed theoretical and phenomenological analysis of different modified gravity models and investigate their consistency. We also consider the cosmological implications of well motivated physical models of the early universe with a particular emphasis on inflation and topological defects. Astrophysical and cosmological tests over a wide range of scales, from the solar system to the observable horizon, severely restrict the allowed models of the Universe. Here, we review several observational probes -- including gravitational lensing, galaxy clusters, cosmic microwave background temperature and polarization, supernova and baryon acoustic oscillations measurements -- and their relevance in constraining our cosmological description of the Universe.Comment: 94 pages, 14 figures. Review paper accepted for publication in a Special Issue of Symmetry. "Symmetry: Feature Papers 2016". V2: Matches published version, now 79 pages (new format

Does the Hyperglycemia Impact on COVID-19 Outcomes Depend upon the Presence of Diabetes?-An Observational Study

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Metabolic syndrome risk factors in overweight, obese, and extremely obese brazilian adolescents

Background: Obesity in infancy and adolescence has acquired epidemic dimensions worldwide and is considered a risk factor for a number of disorders that can manifest at an early age, such as Metabolic Syndrome (MS). in this study, we evaluated overweight, obese, and extremely obese adolescents for the presence of MS, and studied the prevalence of single factors of the syndrome in this population.Methods: A total of 321 adolescents (174 females and 147 males) aged 10 to 16 years, attending the Adolescent Outpatient Clinic of Botucatu School of Medicine, Brazil, between April 2009 and April 2011 were enrolled in this study. Adolescents underwent anthropometric evaluation (weight, height, and abdominal circumference) and Body Mass Index (BMI) was estimated according to age and gender, following Disease Control and Prevention Centers recommendations (CDC, 2000). Blood pressure was measured and individuals with BMI >= 85th percentile were submitted to laboratory evaluation for Total Cholesterol, HDL and LDL Cholesterol, Triglycerides, Fasting Insulinemia, and Fasting Glycemia to identify MS factors, according to the criteria suggested by the International Diabetes Federation. Insulin resistance was calculated by HOMA-IR, Quicki, and Fasting Glycemia/Fasting Insulinemia (FGI).Results and discussion: of the 321 adolescents, 95 (29.6%) were overweight, 129 (40.2%) were obese, and 97 (30.2%) were extremely obese. Around 18% were diagnosed with MS. the most prevalent risk factors were abdominal circumference >= 90th percentile (55%), HDL = 130/85 mm/Hg (21%), Triglycerides >= 150 mg/dL (18.5%), and Fasting Glycemia >= 100 mg/dL (2%). Insulin resistance was observed in 65% of the adolescents.Conclusion: An increased prevalence of overweight and obesity, together with cardiometabolic risk factors such as dyslipidemia and abnormal blood pressure, were observed in adolescents, contributing to the onset of metabolic syndrome at younger ages. Risk factors for MS were more prevalent in females.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)São Paulo State Univ UNESP, Botucatu Sch Med, Dept Pediat, São Paulo, BrazilSão Paulo State Univ UNESP, Botucatu Sch Med, Adolescent Med Course, Post Grad Program Gynecol Obstet & Mastol,Dept Pe, São Paulo, BrazilUniv North Parana, Dept Phys Educ, Curitiba, Parana, BrazilSão Paulo State Univ UNESP, Botucatu Sch Med, Dept Pediat, Clin & Expt Pediat Res Ctr, São Paulo, BrazilSão Paulo State Univ UNESP, Botucatu Sch Med, São Paulo, BrazilSão Paulo State Univ UNESP, Botucatu Sch Med, Dept Stat, São Paulo, BrazilFAPESP: 2011/05991-0Web of Scienc